Casualties unknown

2010-07-16: de Havilland DHC-2, C-GAXL — Air Saguenay (1980) Inc. — Lake Péribonka, Quebec, 12 nm WSW, CA

Lake Péribonka, Quebec, 12 nm WSW, CA

On July 16, 2010, a de Havilland DHC-2, C-GAXL operated by Air Saguenay (1980) Inc. was involved in an aviation accident near Lake Péribonka, Quebec, 12 nm WSW, CA. Investigators recorded the probable cause as: The pilot took off in weather conditions below the minimum for visual flight rules and continued the flight, leading to a controlled flight into terrain. This summary draws on records from the Transportation Safety Board of Canada (TSB); 1 related events involving the same aircraft type or operator are linked below.

Sourcesthe Transportation Safety Board of Canada (TSB)Primary reportUpdated 1785068748Data APIEditorial standards

A float-equipped de Havilland Beaver DHC-2 (C-GAXL) operated by Air Saguenay struck a mountain near Lac Péribonka, Quebec, during a VFR flight in adverse weather. The pilot and three passengers were killed; one passenger was seriously injured and one minor. No ELT signal was received.

Accident Overview

On an unspecified date, a float-equipped de Havilland Beaver DHC-2 Mk.I, registration C-GAXL (serial number 1032), operated by Air Saguenay (1980) Inc., departed from Lac des Quatre, Quebec, en route to Lac Margane, Quebec, under visual flight rules (VFR). The aircraft carried one pilot and five passengers. Approximately 12 nautical miles west-south-west of the southern part of Lac Péribonka, the aircraft struck a mountain at around 100 feet below the peak. The aircraft was destroyed and partially consumed by a post-impact fire. The pilot and three passengers were killed; one passenger sustained serious injuries and one passenger sustained minor injuries. No emergency locator transmitter (ELT) signal was received.

Aircraft and Crew Information

The aircraft was a de Havilland Beaver DHC-2 Mk.I, equipped with floats. The pilot had over 10 years of experience in the area on this type of seaplane. The flight was conducted under Subpart 3 of Part VII of the Canadian Aviation Regulations (CARs) in uncontrolled airspace.

Flight History

The flight was a return trip from Lac Margane, about 40 minutes duration, to retrieve a group of five cottagers left at Lac des Quatre on 11 July 2010. The pilot had another flight scheduled later that day around 1600 EDT. At 0740, the aircraft took off from Lac Margane to assess weather conditions en route, intending to make a precautionary landing if VFR flight became impossible. After arriving at Lac des Quatre, the pilot decided to return despite weather conditions that were below VFR minima. A few minutes after take-off from Lac des Quatre, the pilot reported intentions of a precautionary landing due to adverse weather. The aircraft subsequently struck a mountain.

Weather Conditions

The air mass was humid with calm winds. A cold front had passed, shifting wind from south to southwest. An upward airflow from the southwest in the Chute des Passes area, combined with very humid air, promoted persistent low ceilings. Light drizzle conditions prevailed; it was not raining at the time of the accident. At Lac des Quatre departure, the cloud base was below 250 feet above the lake surface, with visibility limited to the end of the lake. The GFA had forecast ceiling of 800 feet agl and visibility of 2 miles, but the actual ceiling was below 300 feet as clouds covered mountain peaks about 250 feet above the lake. The weather conditions at take-off were below CARs VFR minima.

Accident Details

Examination of the wreckage revealed no structural defect, control malfunction, or loss of power. The aircraft struck the mountain in level flight. The pilot likely focused on maintaining visual reference, reducing attention to the GPS screen. No avoidance maneuver was performed. The GPS ground proximity alerts at less than 100 feet were frequent during low-level flight, limiting their usefulness.

Survival Aspects

Upon impact, the pilot and front passenger cabin area was compressed, resulting in no chance of survival. Three passengers in middle seats were held secure and initially survived. The rear passenger was ejected from the aircraft; that seat was not compliant with aeronautical standards and may have allowed the seat belt to fail. The ELT was damaged and did not transmit. The operator did not notify the Joint Rescue Coordination Centre until 1500, over three and a half hours after the accident, though this delay did not affect survival.

Investigation Findings

The investigation concluded that the pilot took off in weather conditions below VFR minima and continued the flight, leading to controlled flight into terrain (CFIT). The pilot's decision was likely influenced by past successful flights in similar conditions and the ability to assess weather after take-off. No communication with the operations manager existed, and the pilot made the decision alone. The lack of training on pilot decision-making for air taxi operators increased risk in adverse weather. Passenger education on VFR minima could encourage questioning of pilot decisions.

Probable cause

The pilot took off in weather conditions below the minimum for visual flight rules and continued the flight, leading to a controlled flight into terrain.